Utilization Management Nurse Consultant - Weekend Role

January 1

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Description

•Utilize clinical skills to coordinate, document and communicate aspects of the utilization/benefit management program •Ensure members receive appropriate care at the appropriate time and location •Review written clinical records •Assess, plan, implement, coordinate, monitor and evaluate options for healthcare services •Apply clinical criteria/guidelines and judgment to render coverage determination •Communicate with providers to facilitate care/treatment •Identify members for referral opportunities •Promote quality effectiveness of Healthcare Services

Requirements

•3+ years of experience as a Registered Nurse •Active RN licensure in state of residence •1+ years of clinical experience in an acute or post-acute setting •Strong technology skills with Excel preferred •Managed Care experience preferred

Benefits

•Medical benefits •Dental benefits •Vision benefits •401(k) retirement savings plan •Employee Stock Purchase Plan •Fully-paid term life insurance •Short-term and long-term disability benefits •Well-being programs •Education assistance •Free development courses •CVS store discount •Discount programs with participating partners •Paid Time Off (PTO) •Paid holidays throughout the year